DOX方案新辅助化疗对进展期胃癌的疗效分析
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DOX as neoadjuvant chemotherapy in the treatment of advanced gastric cancer
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    摘要:

    目的:探讨多西紫杉醇-奥沙利铂-希罗达(DOX)方案新辅助化疗在进展期胃癌治疗中的作用。方法:收集2008年10月~2011年3月本院确诊进展期胃癌的患者58例纳入化疗组,术前行DOX方案2周期,于化疗后14~21 d期间行手术治疗。同期收治的未经新辅助化疗的进展期胃癌58例作为对照,对照组确诊后2周内手术,术后根据胃癌的规范治疗原则行辅助化疗。结果:化疗组患者均完成术前新辅助化疗,化疗后评估:完全缓解(CR)5例,部分缓解(PR)32例,疾病稳定(SD)20例,疾病进展(PD)l例,总有效率为63.8%。R0切除率明显高于对照组(87.9% vs 63.8%,P < 0.05),其中食管胃交界癌(EGC)CR 3例,PR 12例较远端胃癌CR 2例,PR 20例效果更加显著(P < 0.05)。主要不良反应为粒细胞减少-胃肠道不良反应-外周神经毒性等;术后并发症发生率差异无统计学意义(3.4% vs 1.7%,P > 0.05),两组1年生存率均为100%,化疗组2年生存率明显高于对照组(75.8% vs 55.1%,P < 0.05)。结论:DOX方案新辅助化疗治疗进展期胃癌,尤其是食管胃交界癌,有效率高,患者耐受性及依从性好,可缩小瘤体,降低分期,提高R0切除率,提高生存率。

    Abstract:

    Objective:To explore the efficacy of neoadjuvant chemotherapy in the treatment of advanced gastric cancer. Methods:From October 2008 to March 2011,58 operable patients with stageⅡ~Ⅲc gastric cancer received DOX as neoadjuvant chemotherapy before surgery,and 58 cases of advanced gastric cancer that were not treated with neoadjuvant chemotherapy at the corresponding time period were designated as the controls and underwent surgery within two weeks. According to status of the patients and the principles of standard treatment for gastric cancer,they received postoperative chemotherapy. Results:In the chemotherapy group,there were 5 CR cases,36 PR cases,16 SD cases,and 1 PD case. The total effective rate was 63.8%. The R0 resection rate was significantly higher than that in the control group(87.9% vs 63.8%,P < 0.05). The effective rate of esophagogastric cancer(EGC) was higher than the distal gastric cancer(83.3% vs. 55.0%,P < 0.05). The most common side effects were granulocytopenia,gastrointestinal tract adverse reaction,and periphery neurotoxicity. There was no significant difference in the incidence of postoperative complications(3.4% vs 1.7%)between the two groups. The one-year survival rates of the two groups were both 100%. The two-year survival rate in the chemotherapy group was significantly higher than that in the control group(75.8% vs 55.1%,P < 0.05). Conclusion:The efficacy of DOX as neoadjuvant chemotherapy in the treatment of advanced gastric cancer especially EGC can reduce the tumor size and tumor stage as well as improve R0 resection rate and overall survival.

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魏 尉,李东正,顾荣民,陈环球,文 旭. DOX方案新辅助化疗对进展期胃癌的疗效分析[J].南京医科大学学报(自然科学版),2013,(10):1415-1418

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  • 收稿日期:2013-06-30
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  • 在线发布日期: 2013-10-23
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